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Action

Inhibits the enzyme aromatase, which is partially responsible for conversion of precursors to estrogen. Therapeutic Effects: Lowers levels of circulating estrogen, which may halt progression of estrogen-sensitive breast cancer.

Assess any back pain, bone pain, or other musculoskeletal pain. Suggest additional tests (radiography, MRI) as needed to rule out fracture.

Be alert for signs of paresthesia (numbness, tingling). Establish baseline electroneuromyographic values at the beginning of drug treatment whenever possible, and reexamine these values periodically to document drug-induced changes in peripheral nerve function.

Assess dizziness that might affect gait, balance, and other functional activities (See Appendix C). Report balance problems and functional limitations to the physician and nursing staff, and caution the patient and family/caregivers to guard against falls and trauma.

Interventions

For patients who are medically able to begin exercise, implement appropriate resistive exercises and aerobic training to maintain muscle strength and aerobic capacity during cancer chemotherapy, or to help restore function after chemotherapy.

Patient/Client-Related Instruction

Advise patient and family/caregivers that fatigue and weakness are likely and may be severe. Functional abilities may be limited, and patient may need to use assistive devices during ambulation.

Advise patient about the likelihood of GI reactions such as diarrhea, nausea, vomiting, constipation, abdominal pain, and loss of appetite. Instruct patient or family and caregivers to report severe or unexpected GI reactions.